Ultrasound Measurement of Septic Shock‐induced Acute Skeletal Muscle Atrophy in Intensive Care Unit

• Published in: PM & R Vol. 13; no. 4; pp. 347 - 352
• Main Authors: Tanaka, Kohei, Yamada, Tomoki
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2021
• ISSN: 1934-1482; 1934-1563; 1934-1563
• DOI: 10.1002/pmrj.12406

Background Skeletal muscle wasting progresses rapidly during critical care. However, the effect of skeletal muscle changes on physical function during intensive care remain poorly understood. Objective To examine the changes in skeletal muscle thickness of patients admitted to the intensive care unit (ICU) for septic shock and the relationship between skeletal muscle thickness and physical function following intensive care. Design Longitudinal observational study. Setting Single emergency hospital. Patients Ten septic shock patients who were mechanically ventilated in the ICU were recruited. Interventions Not applicable. Methods Ultrasound measurements of thickness of rectus femoris (RF) were conducted within 24 hours after admission and repeated every two days until the 14th hospital day. The correlations between TRF and various parametric data (i.e., age, severity classification, mechanically ventilated period, length of stay (LOS) at the ICU, and physical function) correlations were assessed with Pearson's product moment coefficient of correlation. Main Outcome Measure(s) Curve estimation for best fit for chronological changes in TRF with respect to the HD and the correlation between TRF and clinical indicators. Results Eight septic shock patients were observed completely for 14 days. TRF decreased linearly by 30.6% (IQR: 23.9‐45.7) during the first 14 days. The correlation between TRF at admission and physical function at the 30th hospital day was close to significant. The TRF at the 14th hospital day was negatively correlated with disease severity and age. A positive correlation was observed between the decrease in rate of TRF and LOS at the ICU. Conclusion Skeletal muscle thickness of septic shock patients rapidly decreased in a linear manner over 14 days and may predict physical function after critical care.